CPT 69990 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Operating Microscope Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
National average reimbursement for CPT 69990 by major payers:
$260.34
$287.35
$312.06
$351.38
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 69990 | ||||||
United | 69990 | $962.54 | 1720334097 - PACIFIC SURGERY CENTER, LLC | 460598503 - PACIFIC SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $341.00 | 1598949281 - POWAY CA MULTI SPECIALTY ASC LLC, POWAY SURGERY CENTER | 261158191 - (CA) POWAY CA MULTI-SPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $561.00 | 1922230853 - CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | 270476822 - (NY) CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $153.00 | 1508840893 - PARKWAY SURGERY CENTER | 621799370 - (SC) PARKWAY SURGERY CENTER, LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $555.00 | 1942851639 - NORTHERN MICHIGAN SURGICAL SUITES, LLC | 830670803 - (MI) NORTHERN MICHIGAN SURGICAL SUITES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $1551.00 | 1396901542 - TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | 750972805 - (TX) TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $150.00 | 1285108845 - MARIETTA ADVANCED SURGERY CENTER | 832382468 - (GA) MARIETTA ADVANCED SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $466.00 | 1649931072 - MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS, LLC, MEDICAL CITY ORTHOPEDIC & SPINE SURGERY CENTER DALLAS | 842824507 - (TX) MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $50.00 | 1972577161 - TAMPA FL ENDOSCOPY ASC LLC, TAMPA BAY ENDOSCOPY CENTER | 200073189 - (FL) TAMPA FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $531.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $555.00 | 1053721530 - WISCONSIN SPECIALTY SURGERY CENTER,LLC | 464559699 - (WI) WISCONSIN SPECIALTY SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $155.00 | 1669474748 - ARC KENTUCKY LLC, DUPONT SURGERY CENTER | 621754364 - (KY) ARC KENTUCKY LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $557.00 | 1679523351 - SURGERY CENTER OF PORT CHARLOTTE LTD | 201327093 - (FL) SURGERY CENTER OF PORT CHARLOTTE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $142.00 | 1558497263 - ARTHUR N DONALDSON M D INC, SONORA EYE SURGERY CENTER | 942593611 - ARTHUR N DONALDSON MD INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69990 | $331.00 | 1750312435 - CENTRAL ARIZONA ENDOSCOPY LLC | 203643513 - (AZ) CENTRAL ARIZONA ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 69990 vs. Other Operating Microscope Procedures Codes
The CPT 69990 code is part of the Surgery services used for Operating Microscope Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 69990 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69990. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69990 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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